Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

Backers of the pill have been seeking the federal action, arguing that easy access to the product, sold under the trade name Plan B, would prevent thousands of unwanted pregnancies.

Opponents argue that being able to obtain the product without a prescription could lead women, particularly young teens, to experiment with risky sex.

The Food and Drug Administration rejected the over-the-counter proposal last year, citing lack of information about the effect on teenagers.

The manufacturer, Barr Pharmaceuticals, applied again six months ago, proposing that Plan B be made available without prescription to women 16 and over. A prescription still would be required for anyone under 16.

‘Ignoring its mandate’Hours after the company announced the delay, the Center for Reproductive Rights filed suit against the FDA for failing to approve Plan B for over-the-counter access. The suit, filed in federal court in New York, contended the FDA didn’t follow its own procedures or statutory and regulatory mandates when it first denied the application, the center said.

“Half of the 3 million pregnancies in the U.S. are unintended each year,” Nancy Northup, the center’s president, said in a statement. “By denying women over-the-counter access to a safe and effective drug that would significantly reduce those numbers — including pregnancies that end in abortion — the FDA is acting unlawfully and ignoring its mandate to advance the public health.”

Under federal guidelines, the FDA had aimed to have a decision by Friday. But Barr Pharmaceuticals said in a statement Friday that the FDA told the company it was unable to complete its review by then.

‘The company remains optimistic’“The company remains optimistic that the agency will approve Plan B for OTC sale,” Barr said.

The statement said the FDA indicated that “it is committed to completing its review of the application in the near future.”

Nancy Keenan, president of NARAL Pro-Choice America, said, “I certainly hope FDA’s decision isn’t motivated by political considerations three days before President Bush’s supporters stage their annual anti-choice protest in Washington.”

Saturday is the 32nd anniversary of the Supreme Court decision legalizing abortion, and anti-abortion activists are gathering in Washington for their annual March for Life rally Monday.

Neither side argues against the safety or effectiveness of the morning-after drug. It’s a higher dose of the contraceptive hormones that is found in birth control pills. It prevents ovulation or fertilization and can keep a fertilized egg from implanting into the uterus.